Two More Individuals Sentenced for Their Roles in Large-Scale Medicare Fraud Scheme

Two More Individuals Sentenced for Their Roles in Large-Scale Medicare Fraud Scheme

BATON ROUGE, LA—A facility administrator and mental health therapist have been sentenced for their roles in an extensive Medicare fraud scheme. Chief U.S. District Court Judge Brian A. Jackson sentenced the individuals as follows:

ARTHUR SMITH, JR., age 32, of Baton Rouge, Louisiana. According to court documents, SMITH was employed at Shifa and Serenity Community Mental Health Centers from in or around 2005 through in or around 2011, and became a managing employee and administrator of Serenity Center in 2008. On numerous occasions, SMITH would falsify documents, including patient records, group progress notes, and other medical documentation, to make it appear as though social workers had provided services and/or treatments to patients, despite the fact that the treatments had not been provided. On September 2, 2014, SMITH was sentenced to a 30-month term of imprisonment, a two-year term of supervised release following his release from imprisonment, and restitution in the amount of $14,146,106.

ANNA NGANG, age 56, of Houston, Texas. From in or around 2010 through in or around 2012, NGANG was employed by Shifa Texas as a therapist tasked with conducting group therapy sessions. At the direction of her supervisors, NGANG knowingly participated in the falsification of documents, including patient records, group progress notes, and other medical documentation, so that her supervisors could use the false documents to support false claims to Medicare. On September 2, 2014, NGANG was sentenced to a 10-month term of imprisonment and $52,308 in restitution.

According to documents filed in the case, the investigation into three community mental health centers—Shifa Community Mental Health Center of Baton Rouge, Serenity Center of Baton Rouge, and Shifa Community Mental Health Center of Texas—was opened in 2011, and since then has resulted in the convictions of seventeen (17) individuals employed by the facilities, including therapists, marketers, administrators, owners and the medical director. Over a period of approximately seven years, the companies billed Medicare for partial hospitalization program services for the mentally ill that were unnecessary or never provided. The companies, collectively, submitted more than $258 million in claims to Medicare during this period. Medicare paid approximately $43.5 million on those claims.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney for the Middle District of Louisiana J. Walter Green, Special Agent-in- Charge Mike Fields of the Dallas Region of the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG), Special Agent-in-Charge Michael Anderson of the FBI’s New Orleans Division, and Louisiana State Attorney General James Buddy Caldwell made the announcement.

The case is being investigated by HHS-OIG, the FBI, and the Medicaid Fraud Control Unit of the Louisiana Attorney General’s Office, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Middle District of Louisiana. The case is being prosecuted by Trial Attorneys Abigail Taylor and Dustin M. Davis of the Criminal Division’s Fraud Section and Assistant United States Attorney Shubhra Shivpuri of the U.S. Attorney’s Office for the Middle District of Louisiana.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 1,900 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.